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Telephone Triage in the Emergency Department: A Collaborative Outcome Lincoln Medical & Mental Health Center member of NYC Health & Hospitals Corporation(HHC)

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Presentation on theme: "Telephone Triage in the Emergency Department: A Collaborative Outcome Lincoln Medical & Mental Health Center member of NYC Health & Hospitals Corporation(HHC)"— Presentation transcript:

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2 Telephone Triage in the Emergency Department: A Collaborative Outcome Lincoln Medical & Mental Health Center member of NYC Health & Hospitals Corporation(HHC) member of Generations+/Northern Manhattan Health Network

3 Purpose Meet the challenges of Managed Care by providing the South Bronx community an effective alternative to access healthcare. Decrease overcrowding in the ER

4 Goals Improve the quality and reliability of the service Provide an alternative to the ER for low acuity problems Facilitate appointment for managed care patient to primary care services Provide the community with reliable access to heath care information

5 PI Methodology P - lan D - esign M – easure A - ssess I - mprove

6 PDMAI Approach Design Procedures/Protocols Patient Environment/ Equipment Provider Quality Telephone Triage Pediatric Protocols Adult Protocols Staffing effectiveness Follow-up on no answer Management and follow-up of panic values Patient Acuity Language barrier Phone rings a long time before being answered Community outreach /education materials TTY Machine Cyracom Phones Computers Awareness/ understanding of the service Assessment Protocol Quality of Care

7 Design Triage RN may consult with provider/PCP at anytime during the process Patient initiates phone contact Call comes into appointment unit Call comes into Telephone Triage unit Call comes from laboratory Panic Values Call comes into ER RN answers phone RN assesses situation Urgent? Clinic appointment scheduled Patient referred to nearest ER or 911 contacted RN documents case Emergent call Advice only LMMHC/Belvis/Morrisania RN gives patient appointment (24 hour window) Urgent call Appointment unit notified of time frame for appointment Appointment only LMMHC/Belvis/Morrisania Call transferred to appointment unit Follow-up of all pediatric and some adult cases Follow-up on ER Referrals Clerk answers phone Yes No

8 Patient Disposition Emergency Referral Urgent (Same day) Urgent clinic appointment (within hrs) Clinic appointment (48-72hrs) - sick visit but not urgent Clinic appointment (visit within four days or more) - not a sick visit

9 Telephone Triage History 7/29/96 - Lincoln Pediatric calls 9/06/96 - Lincoln Adult calls 5/98 - Belvis Pediatrics and Adult calls 10/98 - Other clinic Pediatric and Adult 4/24/00 - Morrisania Pediatric and Adult calls

10 Total Number of Calls


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